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British Liver Trust
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Don’t know what to think!

Don’t know what to think!

Hey

I’m in my late 30s but drank heavily for many many years, mainly wine! I’ve given alcohol up for good! Have cherry anogimas, pale poop, itchy skin that comes and goes, abdominal pain. Had normal bloods GGT, Albumin, PT, ALT, ALP all in normal ranges. Had 2 abdominal ultrasounds and they have come back normal. Worst of all I have Terry’s nails on 4 toe nails. Attached pic! I’ve read Terry’s nails show up in 80% of people with cirrhosis. My GP wouldn’t refer me to Hepatologist based on my ultrasounds and bloods. I called and spoke to a secretary of a heptologist (private) and raised my concerns, she told me it would have shown up in bloods and ultrasound if I had cirrhosis. I’m just lost and really feel I have all the symptoms of this, Terry’s nails made me think it more. Excuse my foot!

Any advice welcome!

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I developed what appeared to be "Terry's Toes" myself, which I found disturbing. Fingers were all OK. I also developed some dermal vascular lesions on my face & chest.

I googled around for hours one evening trying to find out if there was such a thing as Terry's toes, and couldn't find a single thing on Terry's presenting in the toes. I should think if this occurred and was associated with liver disease, someone would have documented this somewhere.

Had an ASH Fibrosure earlier this year which showed F-0. NO Fibrosis! Terry's toes are still as dramatic as ever. Don't know what to make of this, but it appears to be a non-issue regarding liver disease; at least in my experience.

If you have no sign of Terry's in your fingers, I'd say this is a good sign.

Pale stools & itching may indicate sluggish bile flow. The liver needs "choline" to make bile, and Lecithin (aka: phosphatidylcholine) found in egg yolks is the best source of this. You might try adding a few eggs per week into your diet and see if this helps. You should see some results fairly swiftly if choline deficiency is causing your problem.

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I have toe nails that have the moon crescent. Those are pretty much normal, real Terry's nails are almost like frost colored. If you've seen real Terry's nails, you'd see the difference. You hear of people having cirrhosis with normal labs, but most of the time that isn't the case. Albumin normally will be low and globulin will be increased. A/G ratio will normally be low. I thought I had all of this too and then had a ASH Fibro aswell, it was F0 and my fibroscan was a 4.8. Although, I didn't drink it was painkillers that made me sick with drug induced hep. If you can't get over the fact of thinking you have end stage liver disease, which is when you see Terrys. A private fibroscan can help ease your mind, if it comes back good. Your doing the right thing for your liver right now and really all you can do and that's staying away from alcohol.

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The white you're seeing is just vasculature. Depending on the way your sitting, standing, ect the blood will settle differently within the toe nails. I'd show a doctor, but I'm guessing you'll get the same answer. You're nails look a lot better than those ones in the picture. The picture doesn't really allow you to see the texture of the nail.

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Thanks x

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